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NPI Code Detail

MEDICARE: RIVERTON FAMILY HEALTH CENTER LLC

MEDICARE: RIVERTON FAMILY HEALTH CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2207Q00000XFamily Medicine Physician23511UT

General Provider Information

NPI Number : 1528055431
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVERTON FAMILY HEALTH CENTER LLC
Provider Business Mailing Address
First Line : 1756 PARK AVE
Second Line :
City : RIVERTON
State : UT
Zip : 84065-4701
Country : US
Telephone Number : 801-254-0309
Fax Number : 801-254-1012
Provider Business Practice Location Address
First Line : 1756 PARK AVE
Second Line :
City : RIVERTON
State : UT
Zip : 84065-4701
Country : US
Telephone Number : 801-254-0309
Fax Number : 801-254-1012
Authorized Official
Title or Position : OFFICE MANAGER
Name : AARON C MONSON
Credential :
Telephone Number : 801-254-0309
Provider Enumeration Date : 10/05/2005
Last Update Date : 11/26/2024

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Directions to “RIVERTON FAMILY HEALTH CENTER LLC ” Practice Location

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